OBJECTIVE: This study reports on the preliminary psychometric evaluation of the Transsexual Voice Questionnaire for Male-to-Female Transsexuals (MtF)-TVQ(MtF), a tool designed to measure the perceptions of MtF transsexuals regarding their voice. The TVQ(MtF) evolved from an extensive review of the existing Transgender Self-evaluation Questionnaire (TSEQ). STUDY DESIGN: This study was conducted in two phases. In phase I, the TSEQ was reviewed. In phase II, classical test theory was applied to examine two psychometric properties (internal consistency and test-retest reliability) of the TVQ(MtF). METHOD: In phase I, two speech pathologists and two MtF individuals reviewed the TSEQ, and a comparison was made with the results of a thematic analysis of 137 voice-related extracts from the transcripts of in-depth interviews with 14 MtF individuals. In phase II, 29 Australian and six Canadian MtF transsexuals completed the new tool, the TVQ(MtF) twice with an interim period of 4-6 weeks to enable psychometric evaluation. RESULTS: Phase I led to substantial changes to the content and structure of the original measure, the TSEQ, and the subsequent development of the TVQ(MtF). In phase II, internal consistency of the TVQ(MtF) was found to be high (time 1 Cronbach's α=.964; time 2 α=.974). Excellent test-retest reliability was demonstrated (intraclass correlation coefficient=0.979; 95% confidence interval=0.968-0.988). CONCLUSIONS: This study provides psychometric evidence of the reliability of the TVQ(MtF). The MtF participants in this study reported a wide range of vocal functioning and voice-related difficulties. Voice pitch was reported as the most problematic aspect of vocal functioning, and psychosocial issues were the most frequently reported voice-related impacts.